HDFC ERGO vs Kotak General Health Insurance

Compare HDFC ERGO vs Kotak General Health Insurance Plans
Plan Type
Health
Coverage type
Coverage State
Coverage City
Coverage amount
Date of birth
  OR age    years
Policy duration
Gender
Start date
End date
HDFC Ergo Kotak General
Claims Settlement Ratio ** 62.73% 77.71%
Number of Lives Covered * 27,48,000 4,39,000
Network Hospitals 6,000 + 3,900 +
  • * As per IRDAI report for 2018-19
  • ** As per NL25 data published on the Insurance Company website
Hdfc ergo Hdfc ergo Hdfc ergo Kotak General Care Kotak General Premier Kotak General Arogya Sanjeevani
Health Suraksha Health Suraksha Silver Arogya Sanjeevani Health Care Health Premier Arogya Sanjeevani
In-patient Treatment
Covered Covered Covered Covered Up to base sum insured Covered
Room Rent
At Actual capping on room rent Up to 2% of the sum insured subject to maximum of Rs.5,000 per day. No Cap on room rent for this plan Capped at 1% for sum insured less than equal to 4 lakhs No cap on room rent for this plan Up to 2% of the sum insured subject to maximum of Rs.5,000 per day
ICU Charges
At Actuals Covered Up to 5% of sum insured subject to maximum of Rs.10,000 per day Covered Covered Up to 5% of sum insured subject to maximum of Rs.10,000 per day
Pre-hospitalization
60 days before the date of admission to the hospital 60 days before the date of admission to the hospital 30 days before the date of admission to the hospital Up to 30 days Up to 60 days Up to 30 days
Post-hospitalization
180 days after discharge from the hospital 180 days after discharge from the hospital 60 days after discharge from the hospital Up to 60 days Up to 90 days Up to 60 days
Day Care Procedures
Covered Covered Covered 150 day care procedures are covered 405 day care procedures are covered All day care procedures are covered
Domiciliary Treatment
Covered Covered Covered Not Covered Up to base sum insured Not Covered
Emergency Ambulance
Silver Smart: Rs.2,000
Gold Smart: Rs.3,500
Platinum Smart: Sum insured 20 to 50 lakhs: Rs.3,500;
Sum insured 50 & 75 lakhs : Rs.15,000
Covered Maximum of Rs.2,000 per hospitalisation Up to Rs.1,500 Covers up to Rs.20,000 per year Covered
Dental Treatment
Not Covered Not Covered Dental treatment, necessitated due to disease or injury Not Covered Covered(covered from reward points)
(1 Reward point = 0.25Rupees)
Dental treatment, necessitated due to disease or injury
Bariatric Surgery
Not Covered Not Covered Not Covered Not Covered Not Covered Not Covered
Ayush Benefit
Covered Covered
Expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy
Not Covered Up to base sum insured Covered
Maternity Benefits
Covered(Optional)
(Waiting period : 3 years)
Not Covered Not Covered Not Covered
Advantage: Not Covered
Edge: Up to Rs.25,000 for normal and Rs.35,000 for Cesarean(optional)
Elite: Up to Rs.50,000 for normal and Cesarean(optional)
(Waiting period: 36 months)
Not Covered
New Born baby cover
Up to parent care sum insured(Optional) Not Covered Not Covered Not Covered
Advantage: Not Covered
Edge & Elite: Within Maternity Benefit Sum Insured(optional)
(Waiting period: 3years)
Not Covered
Organ Donor Expenses
Covered Covered Not Covered
Up to Base Annual Sum Insured
(Optional)
Up to base sum insured Not Covered
Vaccination (In case of post bite treatment)
Not Covered Not Covered Not Covered Not Covered Not Covered Not Covered
Health Check-up
Covered
1% of Sum Insured after every 4 consecutive and continuous claim free years with us (Subject to a maximum up to Rs.5,000)
Not Covered For each insured person above 18 years of age, each policy year for specified tests For each insured person above 18 years of age, each policy year for specified tests Covered 56 years and above
Hospital daily allowance
Covered up to Sum Insured Covered up to Sum Insured Not Covered
Rs.500 per day for minimum of Extensions 3 days subject to maximum of 10 days
(Optional)
Advantage: Rs.500 per day for minimum 3 days of hospitalization subject to maximum of 10 days
Edge: Rs.1,000 per day for minimum 3 days of hospitalization subject to maximum of 10 days
Elite: Rs.3,000 per day for minimum 3 days of hospitalization subject to maximum of 10 days
(Optional)
Not Covered
Daily Cash for Accompanying an Insured Child
Not Covered Not Covered Not Covered Not Covered
Advantage: Rs.500 per day for minimum 3 days of hospitalization subject to maximum of 10 days
Edge: Rs.1,000 per day for minimum 3 days of hospitalization subject to maximum of 10 days
Elite: Rs.1,500 per day for minimum 3 days of hospitalization subject to maximum of 10 days
(Optional)
Not Covered
Co-pay
Silver Smart: No co-pay for all treatment, Optional Co pay available between 10%/20%;
Gold Smart : No co-pay for all treatment, Optional Co pay available between 15%/25%;
Platinum Smart: No co-pay for all treatment, Optional Co pay available between 15%/25%
NIL / co-pay applicable upto 20% for treatment in higher class cities 5% co-pay on all claims NIL co-pay for all treatment NIL co-pay for all treatment 5% Co-pay applicable on all claims
Pre-existing diseases coverage
Pre-existing diseases covered after 3 years of continuous coverage Pre-existing diseases covered after 4 years of continuous coverage Pre-existing diseases covered after 4 years of continuous coverage Covered after a waiting period of 4 years
Advantage: Covered after a waiting period of 4 years
Edge: Covered after a waiting period of 4 years
Elite: Covered after a waiting period of 3 years
Covered after a waiting period of 4 years
Restore Benefit
Sum Insured Rebound upto 100% of Sum Insured per year Not Covered Not Covered Up to 100% of base sum insured paid for unrelated illness/accidents Up to 100% of base sum insured for unrelated illness/accidents Not Covered
General waiting period
30 days 30 days 30 days 30 days 30 days 30 days
Renewal Benefit / Cumulative Bonus
Silver Smart & Gold Smart: 10% on base sum insured for every claim free year and up to 100%;
Platinum Smart: 25% on base sum insured for every claim free year and up to 200%
5% on base sum insured for every claim free year and up to 50% 5% on base sum insured for every claim free year and up to 50% 10% for every claim free year up to 50% of sum insured
Advantage: 10% for every claim free year up to 50% of sum insured
Edge: 10% for every claim free year up to 100% of sum insured
Elite: 10% for every claim free year up to 100% of sum insured
5% for every claim free year up to 50% of sum insured
Emergency Air Ambulance
Silver Smart:Not Covered;
Gold Smart: Up to 2 lakhs;
Platinum Smart : Up to 5 lakhs.
Not Covered Not Covered Not Covered
Advantage: Not Covered
Edge: Not Covered
Elite: Up to 10% of base sum insured and subject to a maximum of 5lakhs
(optional)
Not Covered
Available sum insured options
Silver Smart: Rs.3 to 5 Lakhs
Gold Smart: Rs.7.5 to 15 Lakhs
Platinum Smart: Rs.20 to 75 Lakhs
Rs.3 to 50 Lakhs Rs.1 to 5 Lakhs
Individual:
Excel: Rs.2 to 4 Lakhs
Premium: Rs.5 to 25 Lakhs
Floater:
Excel: Rs.3 & 4 Lakhs
Premium: Rs.5 to 25 Lakhs
Advantage: Rs.3 to 10 Lakhs
Edge: Rs.5 to 20 Lakhs
Elite: Rs.10 to 25 Lakhs
Rs.1 to 5 Lakhs
Policy can be purchased for
1/2/3 Years 1/2/3 Years 1 Year 1/2/3 years 1/2/3 years 1 year
Eligibility criteria
Adults from 18 Years to lifetime entry (dependents 91 days to 25 years) Adults from 18 Years to lifetime entry (dependents 91 days to 25 years) Adults from 18 to 65 years (dependents 91 days to 25 years).If the child above 18 years of age is financially independent, he or she shall be ineligible for coverage in the subsequent renewals 5 years onwards, Dependent children between 91 days to 5 years can be covered only if both parents are covered under the policy Adults from 18 to 65 years (dependents 91 days to 17 years) Adults from 18 to 65 years (dependents 91 days to 5 years)
Renewability
Renewal for whole life Renewal for whole life Renewal for whole life Renewal for whole life Renewal for whole life Renewal for whole life
Claims loading
Loading Loading No Loading Loading Loading Loading
Portablity(At the time of renewal)
Yes Yes Yes Yes Yes Yes
Tax Benefits Limit
Income tax benefit under section 80D Income tax benefit under section 80D Income tax benefit under section 80D Income tax benefit under section 80D Income tax benefit under section 80D Income tax benefit under section 80D
Health Insurance Priority

India health insurance blogs and articles

Tips for buying best mediclaim insurance

India health insurance tips and tricks to choose the best medical insurance in India Click here to read more

Top reasons for health insurance claims rejection

Find out the different reasons why a medical insurance claim is rejected, Cashless hospitalization, Reimbursement. Click here to read more

India health insurance coverage, factors and premium calculator

Factors for medical insurance in India, How much is the premium and the coverage offered by India health insurance plans..Click here to read more

India health insurance useful links

How to buy online?

You can buy insurance online by using a credit/debit card, direct funds transfer using NEFT or RTGS or by using a cheque

Know more »

Health insurance benefits

Insurance customers can quickly compare the details of benefits offered under Indian mediclaim insurance policies.

Know more »

Compare health plans

Compare Indian health insurance policies, Health insurance India comparison

Know more »

Portability

Portability Information for Mediclaim Insurance in India

Know more »

India health insurance Blogs

Health Insurance Blogs - Information on health or medical insurance coverage in India.

Know more »

Health insurance FAQ

FAQ related to Indian health insurance. Get answers for any health insurance questions

Know more »

EIndia Health Insurance Partners

  • Tata Aig
  • bajaj-allianz
  • reliance
  • cholamandalam
  • religare health Insurance
  • apollo
  • Star Health
  • max bupa
  • future generali
  • go digit
  • hdfc ergo
  • cigna ttk
  • universal sompo
  • SBI
  • iffco tokio
  • Cigna TTK
  • Aditya Birla
  • Raheja QBE
  • New India Logo
  • Oriental Logo
  • bharti axa health Insurance Plans
  • kotak

Indian Health Insurance Resources

-

ONLINE CHAT

CIN: U66000KA2018PTC117713 | IRDAI Web aggregator License Code Number: IRDAI / INT / WBA /53/ 2018, Valid till 07/08/2022